Table 1.

Summary of primary systematic review findings

SubjectUpdate or new recommendationPrevious recommendationNumber of studiesComments
Adults with newly diagnosed ITP 
Prednisone or dexamethasone Update 2019 recommendation 4  
H. pylori eradication Update 2011 recommendations 7.3.A and 7.3.B  
IVIg Update 2011 recommendation 4.3A  
Combination therapy New  Agents used in combination with steroids:
all-trans retinoic acid
mycophenolate mofetil rhTPO 
Children with newly diagnosed ITP 
Observation or IVIg Update 2019 recommendation 12  
Prednisone or dexamethasone Update 2019 recommendation 15  
Anti-D immunoglobulin or IVIg Update 2019 recommendation 17  
IVIg with or without IV methylprednisolone New   
Adults with ITP for ≥3 mo who are corticosteroid dependent or failed corticosteroids 
TPO-RAs (avatrombopag, eltrombopag, hetrombopag and romiplostim) Update 2019 recommendations 7 and 9 17  
Low-dose Rituximab Update 2019 recommendations 8 and 9  
Splenectomy Update 2019 recommendations 7 and 8  
Fostamatinib New   
Rituximab with or without cyclophosphamide New   
Rituximab with or without all-trans retinoic acid New   
Danazol with or without all-trans retinoic acid New   
Hydroxychloroquine New   
IVIg or eltrombopag for surgery New   
Children with ITP who have non-threatening mucosal bleeding and/or diminished quality of life and do not respond to first-line treatment 
TPO-RAs (eltrombopag and romiplostim) Update 2019 recommendations 19 and 20 1 included in both adult and peds 
TPO-RAs and Rituximab Update Recommendation 19  
Splenectomy Update 2019 recommendations 20 and 21 Included in both adult and peds 
Sirolimus vs cyclosporine New   
Hydroxychloroquine New   
Multiple comparison studies 
Comparative effectiveness in children with ITP    
Network meta-analysis in adults with ITP    
Multiple agents single-center experience    
SubjectUpdate or new recommendationPrevious recommendationNumber of studiesComments
Adults with newly diagnosed ITP 
Prednisone or dexamethasone Update 2019 recommendation 4  
H. pylori eradication Update 2011 recommendations 7.3.A and 7.3.B  
IVIg Update 2011 recommendation 4.3A  
Combination therapy New  Agents used in combination with steroids:
all-trans retinoic acid
mycophenolate mofetil rhTPO 
Children with newly diagnosed ITP 
Observation or IVIg Update 2019 recommendation 12  
Prednisone or dexamethasone Update 2019 recommendation 15  
Anti-D immunoglobulin or IVIg Update 2019 recommendation 17  
IVIg with or without IV methylprednisolone New   
Adults with ITP for ≥3 mo who are corticosteroid dependent or failed corticosteroids 
TPO-RAs (avatrombopag, eltrombopag, hetrombopag and romiplostim) Update 2019 recommendations 7 and 9 17  
Low-dose Rituximab Update 2019 recommendations 8 and 9  
Splenectomy Update 2019 recommendations 7 and 8  
Fostamatinib New   
Rituximab with or without cyclophosphamide New   
Rituximab with or without all-trans retinoic acid New   
Danazol with or without all-trans retinoic acid New   
Hydroxychloroquine New   
IVIg or eltrombopag for surgery New   
Children with ITP who have non-threatening mucosal bleeding and/or diminished quality of life and do not respond to first-line treatment 
TPO-RAs (eltrombopag and romiplostim) Update 2019 recommendations 19 and 20 1 included in both adult and peds 
TPO-RAs and Rituximab Update Recommendation 19  
Splenectomy Update 2019 recommendations 20 and 21 Included in both adult and peds 
Sirolimus vs cyclosporine New   
Hydroxychloroquine New   
Multiple comparison studies 
Comparative effectiveness in children with ITP    
Network meta-analysis in adults with ITP    
Multiple agents single-center experience    
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